Page 148 - Cultural Competence in Health Education

126 Cultural Competence in Health Education and Health Promotion

LEARNING OBJECTIVES
After completing this chapter, you will be able to

■ Identify the cultural factors that need to be taken into consideration in devel-
oping culturally appropriate health education and promotion programs.
■ Recognize the best methods for conducting needs assessments and evalua-
tions of health education and promotion programs targeting culturally diverse
populations.
■ Use health planning models to frame culturally appropriate health education
and promotion programs.

INTRODUCTION

The literature on how to plan, implement, and evaluate health education and promo-
tion programs is abundant (Green & Kreuter, 2005; Israel et al., 1995; Steckler et al.,
1994; Centers for Disease Control and Prevention [CDC], 2005). Numerous models,
theories, and methodologies are available to guide health promotion and education
professionals throughout the complex process of determining a population ’ s most rel-
evant health problems and the most effective ways to address them. Although each
model proposes different approaches, a careful review reveals that all models recom-
mend starting with a needs assessment process that aims to identify, analyze, and pri-
oritize the needs or problems of a given group or community. In many cases, health
educators have already identified a health problem (from a previous assessment or in

the mission of the organization they are working with) and just need to determine the
high - risk populations. However, at other times health educators need to conduct a
more extensive community assessment to analyze more than one health problem. To
accomplish this, they need to collect primary and secondary data to assess the needs of
the target population as well as the behavioral, social, and environmental factors asso-
ciated with them (Doyle & Ward, 2001; McKenzie, Neiger, & Smeltzer, 2005).
The second step in the needs assessment process is an analysis to identify obvious
differences between the current and the ideal health status of the target population.
Once this analysis is done, planning models recommend different strategies to priori-
tize the health problem that will become the focus of the program and the basis on

which goals are defined and appropriate interventions chosen. Some considerations in

making this decision are (1) most significant health problems; (2) availability of
resources, including enough time to address the needs; and (3) availability of suitable
interventions (McKenzie et al., 2005). Planning models also address the design of the
evaluation process that will measure the quality of the program and its success in
reaching the expected outcomes.
Among the best - known health planning models are PRECEDE - PROCEED,
MATCH, CDC - Cynergy, SMART, and intervention mapping. These models have
proven to be effective tools for framing health promotion projects that target

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